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Bribes buy India worst maternal care among G20 nations

MUMBAI — India has the worst standard of maternal care in any major economy. About 50,000 women in the country died during childbirth and from pregnancy-related complications last year, estimates compiled by United Nations agencies showed.

A doctor examining a pregnant woman at a hospital in Kolkata, India. The country’s substandard maternal care perpetuates a cycle of poverty and disease that stifles economic development, said an expert. PHOTO: REUTERS

A doctor examining a pregnant woman at a hospital in Kolkata, India. The country’s substandard maternal care perpetuates a cycle of poverty and disease that stifles economic development, said an expert. PHOTO: REUTERS

MUMBAI — India has the worst standard of maternal care in any major economy. About 50,000 women in the country died during childbirth and from pregnancy-related complications last year, estimates compiled by United Nations agencies showed.

That is the most maternal deaths for any nation — 17 per cent of all such fatalities globally. For every 100,000 live births in India, 190 women die, ranking the country with Indonesia at the bottom of the Group of 20 nations.

Although everyday bribery is rife throughout India, the petty fees extracted from poor women seeking maternity care are especially pernicious. The graft extends from hospital staff, who demand money to change bandages, to elected officials and top bureaucrats responsible for fixing up the state hospitals.

“Everyone up and down the rung of the hierarchy is engaged in corrupt practices,” said Ms Jashodhara Dasgupta, who coordinates a reproductive rights group called Sahayog.

“Those lower down, even if they’re not poorly paid, feel it’s justified to also make a quick buck because everyone from the minister downward and the senior managers are trying to make money out of the patients, the health budget, the hospital fees. We have to see it as a very entrenched system that’s really depriving the poor of resources,” Ms Dasgupta added.

India’s substandard maternal care perpetuates a cycle of poverty and disease that holds back families and stifles economic development, said Mr K Srinath Reddy, president of the New Delhi-based Public Health Foundation of India. The ill effects can last generations, he said. Unhealthy mothers give birth to small babies susceptible to diabetes, heart disease and other chronic illnesses in adulthood.

The fees charged to mothers are so pervasive that some women say they even have to bribe hospital staff to see their own newborns — about 300 rupees (S$6) for a girl and 500 rupees for a boy.

If a mother resists, a hospital worker will say: “No problem; I’m not going to bring your baby back for you,” said Ms Kerry McBroom, director of the reproductive rights initiative at the New Delhi-based Human Rights Law Network.

Women interviewed and those who report their treatment to rights groups say they are routinely asked for money for everything from bandages to blood.

The incentives and bribes underpin a maternal-care system that is overwhelmed by a birth every 1.2 seconds — 26 million babies last year.

Nurses can also be aggressive in extorting money from patients, women who have encountered the mistreatment say.

Ms Bindu, an 18-year-old from a farming village south of Varanasi, hides her face behind the fabric of her multicoloured sari as she recalls the birth of her first child at Mirzapur District Women’s Hospital.

The nurse covered her mouth and hit her leg when she cried during labour, she said. After the baby was born, the nurse asked for 100 rupees for drugs and 500 rupees because Ms Bindu had a son.

Her husband, Mr Sunil, explained that they could afford only 300 rupees. The nurse berated him for not paying the asking price.

“She said, ‘I’ll remember you the next time you come to the hospital ... If there’s a complication and she needs surgery, you’ll need to pay more,’” Mr Sunil recalled.

Since Prime Minister Narendra Modi swept into office in May, his administration has earmarked about 3 billion rupees to test a project that would increase women’s safety on public transportation and establish crisis centres for female victims of violence in New Delhi hospitals, among other initiatives.

Maternal care is a priority, said Mr Harsh Vardhan, who, until last month, was India’s Health Minister. “It’s an area for absolute, thorough, specialised attention for us,” he said in an interview in September.

He added that most healthcare workers are honest. “All these small things that take place somewhere here and there, what you call corruption, they are aberrations,” he said.

“We are strengthening monitoring mechanisms. We have said we are not going to tolerate either corruption or inefficiency.” Bloomberg

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